Ariel O Jusino Cordova, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1147 Issued in PR

Practice address

B12 Calle 2
Villa Real
Vega Baja, PR 00693-5301

Phone

(787) 858-5200

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1831263144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B12 CALLE 2",
            "address_2": "VILLA REAL",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006935301",
            "telephone_number": "787-858-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B12 CALLE 2",
            "address_2": "VILLA REAL",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006935301",
            "telephone_number": "787-858-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSINO CORDOVA",
        "first_name": "ARIEL",
        "middle_name": "O",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL PROVIDER",
            "identifier": "41050",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Alexandrea Jewett, PSYD
• Melvin Jimenez Cordero, MD
• Natalie E. Jimenez Ruiz
• Jmheyecare
• Amarilys Jove
• Shayan Khorsandi, M.D.
• Kidshealth PSC
• Yahaira La Luz Vazquez
• Laboratorio Clinico Almirante Norte Corp
• Laboratorio Clinico Alturas Inc.

• General Practice Dentistry in Vega Baja, PR
• Providers in Vega Baja, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.